Abstract
In their meta-analysis of 301 clinical trials, researchers have compared the safety and efficacy of glucose-lowering drugs in type 2 diabetes. According to their results, the risk of cardiovascular and all-cause mortality did not significantly differ between the various classes of glucose-lowering drugs when given alone or in combination with metformin or sulfonylurea, or both. Relative to metformin monotherapy, HbA1c was higher with α-glucosidase inhibitors (standardised mean difference 0·35, 95% CI 0·12–0·58), sulfonylureas (0·18, 0·01–0·34), DPP-4 inhibitors (0·33, 0·13–0·52), and thiazolidinediones (0·16, 0·00–0·31). There was no difference in HbA1c concentrations between metformin monotherapy and SGLT-2 inhibitors, basal insulin, GLP-1 receptor agonists, and meglitinides. Dual therapy including metformin resulted in similar HbA1c concentrations across the different classes of drugs.
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